Living With Type 1 Diabetes
INSULIN THERAPY
Types of Insulin
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There are several different types of insulin. It is likely that when you are first diagnosed you will be given a rapid-acting dose to take during the day with meals and then a long-action dose to take once at night before you go to bed.
Source: http://www.abpischools.org.uk/page/modules/diabetes_16plus/diabetes6.cfm?coSiteNavigation_allTopic=1
How To Use Insulin
The goal of injecting insulin is to mimic the response of the pancreas to glucose in the blood stream. It’s important to inject immediately before you eat for two reasons: it takes about 10 to 15 minutes for rapid-acting insulin to begin working, and you need to be sure that you will be able to eat immediately once you inject so that you’re not at risk of hypoglycemia.
The Process:
Once you know that you’re going to be eating shortly, you need to follow the following steps:
1. Test Your Blood Sugar
2. Determine Your Insulin Dose
3. Prepare Your Insulin Dose
4. Inject
Testing Your Blood Sugar
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Here’s the most efficient way that I’ve found to test blood sugar:
1. Clean your hands:
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It’s important to clean your hands before your prick your finger, because anything left on your hands that you may have previously come into contact with increases the risk of a false reading. I like to carry a travel-size container of hand sanitizer with me, which is quicker and easier than finding a sink to wash your hands in, particularly if you’re out in public. Once you’ve washed and/or sanitized your hands, make sure they’re completely dry.
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2. Prepare your blood glucose monitor/lancing device.
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I like to insert a test strip into my blood glucose monitor before I draw blood from my finger to give it time to set up and be ready for testing; applying blood to the strip too early can mean that it won’t be able to be tested, and you’ll have to throw out the strip and insert a new one, which just consumes even more time. After I’ve inserted a test strip, I prepare my lancing device. My device requires me to remove the cap and insert a new lancet every time, draw back the cocking mechanism, place the device next to my finger, and release the lancet. If you find that the lancet doesn’t draw enough blood immediately, firmly stroke your finger toward the point of insertion, and the blood flow should pool and provide a greater amount for testing.
Determine Your Insulin Dose
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Once you get a blood glucose reading, you have a general idea of where you are on the spectrum and whether you need to factor in being too high or low into the dose of insulin you take.
If I am on the low end of the spectrum, say below 5 mmol/L, then I consider reducing my insulin dose by a half unit or even a full unit if I’m concerned that taking the full dose might possibly result in hypoglycemia.
If I am high, then I apply my correction factor.
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Correction Factors
A correction factor determines how many mmol/L your blood glucose level will be reduced by per 1 unit of insulin. My personal ratio is 1 unit : 3mmol/L, which means that if I take 1 extra unit of insulin, it will reduce my blood glucose level by 3mmol. This is useful when, say, I check my blood sugar before lunch and discover I miscalculated something at breakfast, which has left my blood glucose level far too high at 12 mmol/L. In order to correct the difference, I add 2 units of insulin onto my dosage at my next meal, in order to bring my blood glucose level down to approximately 6mmol/L, which is in the desired fasting range.
Preparing Your Insulin Dose
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It is probable that you will be using insulin pens that require refillable cartridges of insulin. The pen should come with a cartridge of insulin already installed. The tricky part is when it comes time to remove the cartridge and replace it. It’s relatively easy but here’s a how-to guide:​
Source: http://www.medicineonline.com/drugs/n/4335/NovoLog-insulin-aspart-rDNA-origin-injection.html
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Twist the top half of the pen and the bottom half of the pen away from one another
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Remove the cartridge frame on the top half
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Slip the empty cartridge out and replace with a new one, making sure to push the metal lead screw down, but not too far down
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Re-screw the cartridge frame and the bottom half of the pen together and test to make sure the pen is working properly again
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​Once your pen is properly loaded with insulin, you will need to apply a needle tip. There are different types of needle tips, but you should have a prescription from you doctor that corresponds with the pen that you have. When you are ready to apply a needle tip, peel back the protective and screw the needle tip onto the top of the pen. Remove the outer and inner needs caps. Dial your pen to 1 unit in the dosage window, or if you are using a half unit pen, a half unit, and press the injection push button to ensure that the tip is not defective and insulin is properly being released.
Injecting
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You want to inject into subcutaneous fat, preferably on the abdomen. It’s important not to inject into the same location repeatedly without variation, otherwise you become susceptible to irritation. A good rule of thumb is to work clockwise around the bellybutton or across the abdomen. Once you are ready to inject, insert the tip into your skin – it shouldn’t hurt, and if it does, find a new location – and press the release button. Wait 3 – 5 seconds after injecting to remove the needle. Unscrew the tip from the pen and dispose in a sharps box.
Storing Insulin
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Insulin should be stored in the fridge. Once it has been removed from the fridge, insulin is good for 30 days at room temperature.